Visual Recovery and Clinical Outcomes With Torn Donor Tissue: A Comparative Study on Descemet Membrane Endothelial Keratoplasty.

Purpose: To evaluate the clinical impact of implanting donor tissue torn during preparation for the Descemet membrane endothelial keratoplasty procedure.

Methods: In this single-center retrospective analysis of consecutive cases, 10 cases with torn donor tissue from one surgeon's caseload of 175 procedures were analyzed and compared with control cases. Best-corrected visual acuity, endothelial cell density of the donor tissue measured by specular microscopy, and the recipient's central corneal thickness were recorded preoperatively and again 1, 3, and 6 months after surgery.

Results: In the torn graft group, mean central corneal thickness decreased from 660 ± 81 μm preoperatively to 520 ± 36 μm at 6 months after surgery. central corneal thickness was higher at 1 month but decreased faster between 1 and 3 months in the torn graft group compared with the controls (-86 ± 50.2 μm and -12.6 ± 25.5 μm, respectively, P = 0.04). Best-corrected visual acuity in the torn graft group was 0.25 ± 0.23 logMAR, 0.21 ± 0.20 logMAR, and 0.16 ± 0.16, respectively, at 1, 3, and 6 months after surgery with no significant differences found when compared with controls. The percent endothelial cell loss between the preoperative and 1-month postoperative values was significantly higher in the torn graft group than in the controls (32.3% and 24.6%, respectively, P = 0.04) but was identical at 6 months (35.7% in the torn graft group and 34.8% in the control group).

Conclusions: Anatomical recovery was shown to be slower in patients who received torn donor tissue, but long-term clinical outcomes were similar in both groups.